(Authored article by Dr. Fred Williams, Consultant Endocrinologist, Columbia Asia Hospital, Whitefield)
According to the Annual Health Report (2011) of the Ministry of Health and Family Welfare, Government of India, nearly half of all the deaths in India are primarily due to non-communicable diseases, many of which are linked to inactive and unhealthy lifestyles like cardiovascular diseases, diabetes, diseases resulting from obesity, etc. Unhealthy lifestyles, lack of physical activity, and the increased rates of obesity among the masses are some of the major reasons for people suffering with non-communicable diseases. One such major non-communicable disease affecting people worldwide is diabetes with an increase in the global prevalence among adults over 18 years of age from 4.7% in 1980 to 8.5% in 2014, according to a report by WHO.
According to the International Diabetes Federation South-East Asia, there were 69.1 million cases of diabetes in India in 2015. Having diabetes can also lead to several other co-morbid complications like blindness, kidney failure, heart attacks, stroke etc. Even though diabetics can be managed with tablets and/or insulin shots, to mimic the body’s natural process, it is important to carefully synchronize these insulin injections and blood sugar levels, depending on the body’s need.
Maintaining proper body weight and adopting a healthy lifestyle can go a long way in prevention of diabetes and preventing the progression of the disease. Adopting cycling, as a form of physical activity, can go a long way in preventing and managing diabetes.
Cycling as a form of exercise for diabetic patients
Cycling is highly recommended as a form of exercise. People who travel short distances for work can opt for cycling instead of bikes or cars.
Cycling as part of regular exercise, for about 30 mins a day,can be very helpful for diabetic patients. It is effective in bringing down sugar levels in the body and increasing fitness levels. Cycling is also considered to be easier on the joints as compared to any other form of exercise like jogging, etc. It helps burns calories, improves stamina, increases body muscle mass and can help in controlling Type 2 diabetes and also preventing the progression of diabetes in pre diabetics.
However, any diabetic patient opting for cycling should make sure they consult their doctors to adjust their insulin/medications accordingly.
Managing diabetes for serious cyclists
Even though cycling has a lot of benefits for diabetes patients, intensive cycling or any form of intensive exercise can also lead to irregular blood sugar levels particularly in Type 1 diabetics. The effects can be quite complex but usually results in an upsurge of blood sugar levels transiently followed by lower blood sugar level after few hours. These steep changes in the sugar levels can lead to hypoglycaemia and other complications in diabetic patients particularly in Type 1 diabetics. Your doctor can help you establish a plan, including best times of day to train and how to go about monitoring, adjusting, and ultimately managing your fluctuating glucose levels.
Tips for diabetes patients opting for competitive cycling
Management of Type 1 and type 2 diabetes in these scenarios vary considerably
- Consult your doctor to adjust your treatment.
- Before you start cycling, make sure you check your blood sugar levels. High sugar levels in the bloodstream can also inhibit your performance and hence it is important to make sure they are on the optimum levels.
- On long rides you should make sure to check your blood sugar levels regularly in between or use continuous glucose monitoring systems to make sure there are no irregularities.
- Carry carbohydrates on your rides, as exercise can lead to hypoglycaemia.
- After the event, make sure to check your blood sugar levels and contact your doctor immediately in case of any complications.
- Consider insulin pumps, Continuous glucose monitoring system and other aids
All cyclists, whether diabetic or not, need to restock their muscle glycogen stores to recover from a long and tiring ride. For riders without diabetes, it’s usually the intake of carbohydrates, proteins and hydration that can do the job. However, for diabetic patients it is important to understand your body’s need and act accordingly. A lot of people take a unit or two of insulin right after they get off the bike. This is followed by post-ride meal that is a ratio of four-to-one carbohydrates to protein.
Avoiding hypoglycaemia can be tricky even hours after training and racing has ended. Use of finger-stick style blood glucose meter or a continuous glucose monitor (CGM) helps in these cases as they alert the patients whenever the sugar levels are either too high or low.
It would be ideal if you could try to train at the same time everyday and develop a program that consistently works for you. If this is not possible, the results of blood glucose monitoring are the key to determining how you can safely train, and what pre-exercise and on-bike food and fluid strategies are most effective